| NPI | 1447770458 |
|---|---|
| Former Name | PAIGE STACKPOLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: ME PA1712) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA1712) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2022-12-19 |